Toplumdan Kazanılmış Metisiline Dirençli S. aureus

TK-MRSA toplumdan kazanılmış veya toplumla ilişkili Staphylococcus aureus artan yaygınlıkta görülmeye başlanmış ve belli topluluklarda yeni bir epidemi olarak ortaya çıkmıştır. Hastaneyle ilişkili MRSA Hİ-MRSA hemen daima daha önceden uygulanan medikal tedaviyle ilgili risk faktörlerine sahip kişilerde ortaya çıkıyorsa da TK-MRSA’da bu özellikler bulunmaz. Bu form, daha önceden medikal tedavi almamış veya hastaneye yatmamış sağlıklı kişilerde ortaya çıkan ciddi deri ve yumuşak doku enfeksiyonlarının etkenidir. TK-MRSA; mahkûmlar, koşucular, çocuklar, eşcinsel erkekler ve askeri birliklerde daha sık olarak identifiye edilmiştir. İki tip arasındaki majör farklılık, TK-MRSA’nın Panton-Valentin Lökosidin adı verilen ve lökositlere saldırarak enfeksiyon oluşturan potent bir toksine sahip olmasıdır. TK-MRSA enfeksiyonunun en ciddi formu olan nekrotizan fasiittir. Aynı zamanda ciddi nekrotizan pnömoni ve hematojen osteomiyelitin artmış komplikasyonlarının da nedenidir. USA 300 ve USA 400 olarak adlandırılan İki stafilokok klonu suş TK-MRSA ile ilişkilidir. TK-MRSA, direnç geni olarak stafilokokal kaset kromozomu SCC mec I, II ve III’e sahip olan Hİ-MRSA’nın aksine SCC mec IV ve V’e sahiptir. TK-MRSA halen beta-laktam ve makrolid grubu dışında birkaç antibiyotik grubuna duyarlıdır. Bakteri diğer antibiyotiklere de direnç geliştirebilir. Bu yüzden klinisyenler bu ilaçların kullanımında dikkatli olmalıdırlar

Community Acquired Meticilline Resistance S. Aureus

CA-MRSA community-acquired, or community-associated Staphylococcus aureus has appeared with increasing frequency and is now epidemic within certain community populations. Whereas hospital associated MRSA is almost always found in persons with established risk factors associated with prior medical treatment, these are not present in CA-MRSA. This form causes serious skin and soft tissue infections in otherwise healthy persons who have not been recently hospitalized or undergone invasive medical procedures. CA-MRSA has been identified most frequently among prisoners, athletes, children, men who have sex with men, and military recruits. A major difference between the two types that CA-MRSA possesses a potent toxin called PantonValentine leukocidin, which attacks infection-fighting leukocytes. The most serious form of CA-MRSA infection causes necrotizing fasciitis. Also it causes serious necrotizing pneumonia and increased complications of hematogenous osteomiyelitis. Two clones strains of staph, called USA300 and USA400, are associated with the CA-MRSA. CA-MRSA has stphylococcal casette chrosome SCC mec IV and V as resistance genes unlike HA-MRSA which has I, II and III SCC mec. CA-MRSA is still susceptible to several antibiotic classes outside of the beta-lactam group and macrolides. Bacteria can develope resistance to other antibiotics. Therefore clinicians must be careful at use of them

Keywords:

methicillin resistance, Staphylococcus aureus,

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Herold BC, Immergluck LC, Maranan MC, Lauderdale DS, Gaskin RE, Boyle-Vavra S, et al. Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk. JAMA. 1998;279:593–598.

Frank AL, Marcinak JF, Mangat PD, et al. Increase in community-acquired methicillin-resistant Staphylococcus aureus in children. Clin Infect Dis. 1999; 29: 935–936.

Vandenesch F, Naimi T, Enright MC, Lina G, Nimma GR, Heffernan H, et al. Community-acquired methicillin-resistant Staphylococcus aureus carrying Panton-Valentine leukocidin genes: worldwide emergence. Emerg. Infect. Dis. 2003; 9: 978–984.

Dufour P, Gillet Y, Bes M, Lina G, Vandenesch F, Floret D, et al. Community-acquired methicillin- resistant Staphylococcus aureus infections in France: emergence of a single clone that produces Panton-Valentine leukocidin. Clin Infect Dis. 2002;35: 819–824

Gillet Y, Issartel B, Vanhems P, Fournet JC, Lina G, Bes M, et al. Association between Staphylococcus aureus strains carrying gene for Panton- Valentine leukocidin and highly lethal necrotising pneumonia in young immunocompetent patients. Lancet. 2002;359:753–759

Van de Velde, H. E ´tude sur la me ´canisme de la virulence du staphylocoque pyogene. Cellule 1894;10: 402–460.

Panton PN, Valentine FCO. Staphylococcal toxin. Lancet 1932; 219: 506–508.

Prevost G, Bouakham T, Piemont Y, Monteil H. Characterisation of a synergohymenotropic toxin produced by Staphylococcus intermedius [published correction appears in FEBS Lett. 1996;381:272]. FEBS Lett. 1995;376:135–149.

Genestier AL, Michallet MC, Pre´vost G, Bellot G, Chalabreysse L, Peyrol S, et al. Staphylococcus aureus Panton-Valentine leukocidin directly targets mitochondria and induces Bax-independent apoptosis of human neutrophils. J. Clin. Invest. 2005;115:3117–3127.

Kuehnert MJ, Hill H, McQuillan G, McAllister S, Kruszon-Moran D, Fosheim G, et al. “Prevalence of Staphylococcus aureus colonization in the United States—2001-2002.” Abstract 487 from IDSA 2004 Annual Meeting.

Centers for Disease Control and Prevention. Methicillin-resistant Staphylococcus aureus skin or soft tissue infections in a state prison -- Mississippi, 2000. MMWR Morb Mortal Wkly Rep. Oct 2001;50(42) :919-922.

Centers for Disease Control and Prevention. Methicillin-resistant Staphylococcus aureus infections in correctional facilities -- Georgia, California, and Texas, 2001-2003. MMWR Morb Mortal Wkly Rep. Oct 2003;52(41):992-996.

Centers for Disease Control and Prevention. Methicillin-resistant Staphylococcus aureus infections among competitive sports participants -- Colorado, Indiana, Pennsylvania, and Los Angeles County, 2000-2003. MMWR Morb Mortal Wkly Rep. Aug 2003;52(33):793-795.

Zinderman CE, Conner B, Malakooti MA, LaMar JE, Armstrong A, Bohnker BK. Community-acquired methicillin-resistant Staphylococcus aureus among military recruits. Emerg Infect Dis. May 2004;10(5):941-944.

Shahin R, Johnson IL, Jamieson F, McGeer A, Tolkin J, Ford-Jones EL. Methicillin-resistant Staphylococcus aureus carriage in a child care center following a case of disease. Toronto Child Care Center Study Group. Arch Pediatr Adolesc Med. Aug 1999;153(8):864–868.

Centers for Disease Control and Prevention. Outbreaks of community-associated methicillin-resistant Staphylococcus aureus skin infections--Los Angeles County, California, 2002–2003. MMWR Morb Mortal Wkly Rep. Feb 7 2003;52(5):88.

Baggett HC, Hennessy TW, Rudolph K, Bruden D, Raesonover A, Parkinson AJ. Community-onset methicillin resistant Staphylococcus aureus associated with antibiotic use and the cytotoxin Panton-Valentine leukocidin during a furunculosis outbreak in rural Alaska. J Infect Dis. May 1 2004;189(9):1565–1573.

Moran GJ, Amii RN, Abrahamian FM, Talan DA. Methicillin-resistant Staphylococcus aureus in community-acquired skin infections. Emerg Infect Dis. Jun 2005;11(6):928–930.

Kuehnert MJ, Kruszon-Moran D, Hill HA, McQuillan G, McAllister SK, Fosheim G, et al. Prevalence of Staphylococcus aureus Nasal Colonization in the United States, 2001-2002. J Infect Dis. Jan 15 2006;193(2):172–179.

Creech CB 2nd, Kernodle DS, Alsentzer A, Wilson C, Edwards KM. Increasing rates of nasal carriage of methicillin-resistant Staphylococcus aureus in healthy children. Pediatr Infect Dis J. Jul 2005;24(7):617–621.

Frazee BW, Lynn J, Charlebois ED, Lambert L, Lowery D, Perdreau-Remington F. High prevalence of methicillin-resistant Staphylococcus aureus in emergency department skin and soft tissue infections. Ann Emerg Med. Mar 2005;45(3):311- 320.

Kluytmans J, van Belkum A, Verbrugh H. Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev. Jul 1997;10(3):505–520.

Ellis MW, Hospenthal DR, Dooley DP, Gray PJ, Murray CK. Natural history of community-acquired methicillin-resistant Staphylococcus aureus colonization and infection in soldiers. Clin Infect Dis. Oct 1 2004;39(7):971–979.

Eveillard M, de Lassence A, Lancien E, Barnaud G, Ricard JD, Joly-Guillou ML. Evaluation of a Strategy of Screening Multiple Anatomical Sites for Methicillin- Resistant Staphylococcus aureus at Admission to a Teaching Hospital. Infect Control Hosp Epidemiol. Feb 2006;27(2):181–184.

Boyce JM. Preventing staphylococcal infections by eradicating nasal carriage of Staphylococcus aureus: proceeding with caution. Infect Control Hosp Epidemiol. Dec 1996;17(12):775–779.

Laupland KB, Conly JM. Treatment of Staphylococcus aureus colonization and prophylaxis for infection with topical intranasal mupirocin: an evidence-based review. Clin Infect Dis. Oct 1 2003;37(7):933–938.

Loeb M, Main C, Walker-Dilks C, Eady A. Antimicrobial drugs for treating methicillin-resistant Staphylococcus aureus colonization. Cochrane Database Syst Rev. 2003(4):CD003340.

Bratu S, Eramo A, Kopec R, et al. Community-associated methicillin-resistant Staphylococcus aureus in hospital nursery and maternity units. Emerg Infect Dis. Jun 2005;11(6):808–813.

Healy CM, Hulten KG, Palazzi DL, Campbell JR, Baker CJ. Emergence of new strains of methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit. Clin Infect Dis. Nov 15 2004;39(10):1460–1466.

Saiman L, O’Keefe M, Graham PL, Wu F, Said-Salim B, Kreiswirth B, et al. Hospital transmission of community-acquired methicillin-resistant Staphylococcus aureus among postpartum women. Clin Infect Dis. Nov 15 2003;37(10):1313–1319.

Braun L, Craft D, Williams R, Tuamokumo F, Ottolini M. Increasing clindamycin resistance among methicillin-resistant Staphylococcus aureus in 57 northeast United States military treatment facilities. Pediatr Infect Dis J. Jul 2005;24(7):622–626.

Kaplan SL, Hulten KG, Gonzalez BE, Hammerman WA, Lamberth L, Versalovic J, et al. Three-year surveillance of community-acquired Staphylococcus aureus infections in children. Clin Infect Dis. Jun 15 2005;40(12):1785–1791.

Naimi TS, LeDell KH, Como-Sabetti K, Borchardt SM, Boxrud DJ, Etienne J,et al. Comparison of community- and health care-associated methicillin- resistant Staphylococcus aureus infection. JAMA. Dec 10 2003;290(22):2976–2984.

Ma XX, Ito T, Tiensasitorn C, Jamklang M, Chongtrakool P, Boyle-Vavra S, et al. Novel type of staphylococcal cassette chromosome mec identified in community-acquired methicillin-resistant Staphylococcus aureus strains. Antimicrob Agents Chemother. Apr 2002;46(4):1147–1152.

Lina G, Piemont Y, Godail-Gamot F, Bes M, Peter M, Gauduchon V, et al. Involvement of Panton-Valentine leukocidin-producing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis. Nov 1999;29(5):1128–1132.

double-blind, randomized study. J. Antimicrob. Chermother. 2008; 62(Suppl. 1):i17–i28.

Skrupky LP, Micek ST, Kollef MH. Optimizing therapy for MRSA pneumonia. Semin. Respir. Crit. Care Med. 2007; 28: 615–623.

Meka VG, Pillai SK, Sakoulas G, Wennersten C, Venkataraman L, DeGiroami PC, et al. Linezolid resistance in sequential Staphylococcus aureus isolates associated with a T2500A mutation in the 23S rRNA gene and loss of a single copy of rRNA. J. Infect. Dis. 2004; 190: 311–317.

Rubinstein E, Prokocimer P, Talbot GH. Safety and tolerability of quinupristin/dalfopristin: administration guidelines. J. Antimicrob. Chemother. 1999; 44(Topic A): 37–46.

Dowzicky M, Talbot GH, Feger C, Prokocimer P, Etienne J, Leclerq R. Characterization of isolates associated with emerging resistance to quinupristin/ dalfopristin (Synercid) during a worldwide clinical program. Diagn. Microbiol. Infect. Dis. 2000; 37: 57–62.

Luh KT, Hsueh PR, Teng LJ, Pan HJ, Chen YC, Lu JJ, et al. Quinupristin-dalfopristin resistance among Gram-positive bacteria in Taiwan. Antimicrob. Agents Chemother. 2000; 44: 3374–3380.

Chung M, Antignac A, Kim C, Tomasz A. Comparative study of the susceptibilities of major epidemic clones of methicillin-resistant Staphylococcus aureus to oxacillin and to the new broad-spectrum cephalosporin ceftobiprole. Antimicrob. Agents Chemother. 2008; 52: 2709–2717.

Cohen PR, Kurzrock R. Community-acquired methicillin-resistant Staphylococcus aureus skin infection: an emerging clinical problem. J. Am. Acad. Dermatol. 2004; 50: 277–280.

Zhanel GG, Sniezek G, Schweizer F, Zelenitsky S, Lagace-Wiens PR, Rubinstein E, et al. Ceftaroline: a novel broad-spectrum cephalosporin with activity against meticillin-resistant Staphylococcus aureus. Drugs 2009; 69: 809–831.

Roecker AM, Pope SD. Dalbavancin: a lipoglycopeptide antibacterial for Gram-positive infections. Expert Opin. Pharmacother. 2008; 9: 1745–1754.

Charneski L, Patel PN, Sym D. Telavancin: a novel lipoglycopeptide antibiotic. Ann. Pharmacother. 2009; 43: 928–938.

Poulakou G, Giamarellou H. Oritavancin: a new promising agent in the treatment of infections due to Gram-positive pathogens. Expert Opin. Invest. Drugs 2008; 17: 225–243.

Van Bambeke F. Glycopeptides and glycodepsipeptides in clinical development: a comparative review of their antibacterial spectrum, pharmacokinetics and clinical efŞcacy. Curr. Opin. Invest. Drugs 2006; 7: 740–749.

Hampson FG, Hancock SW, Primhak RA. Disseminated sepsis due to a Panton-Valentine leukocidin producing strain of community acquired meticillin resistant Staphylococcus aureus and use of intravenous immunoglobulin therapy. Arch. Dis. Child. 2006; 91: 201–203.

Gauduchon V, Cozon G, Vandenesch F, Genestier AL, Eyssade N, Peyrol S, et al. Neutralization of Staphylococcus aureus Panton Valentine leukocidin by intravenous immunoglobulin invitro. J. Infect. Dis. 2004; 189: 346–353.

Nathwani D, Morgan M, Masterson RG, Dryden M, Cookson BD, French G, et al. Guidelines for UK practice for the diagnosis and management of methicillin-resistant Staphylococcus aureus (MRSA) infections presenting in the community. J. Antimicrob. Chemother. 2008; 61: 976–994.